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Some of the most important players in setting the rates that Medicare and private insurers pay doctors are — surprise — doctors themselves. And — no surprise — certain procedures end up costing more than they should.

Here's how the system works: A little-known committee run by the American Medical Association, the trade association for doctors, analyzes thousands of procedures that doctors perform and recommends "relative values" to Medicare. More often than not, Medicare accepts the AMA data for its own complex process of setting doctor reimbursement rates.

In some ways, this make sense. Who knows more about the complexities of medical procedures than the people who actually perform them? The AMA's Relative Value Update Committee volunteers for the job and spends huge amounts of time in numbingly detailed discussions about how to value what doctors do.

But the committee is also a flawed operation that operates in semisecret. The panel gathers its raw data by surveying doctors about the time and intensity of the procedures they perform — helpfully reminding physicians that the survey can help set their pay. Is it any shock that the committee has often significantly overvalued procedures by the cardiologists, ophthalmologists and other medical specialists who make up most of its 31 members?

In 2010, for example, The Wall Street Journal reported that the committee was under fire from medical experts for overstating the time it took to place a cardiac stent in a patient's artery or perform carpal tunnel surgery on someone's wrist.

And just this month, The Washington Post found that according to the panel's 75-minute estimate for colonoscopies (including the time of the procedure itself, plus patient preparation and counseling before and after) one doctor had somehow managed to cram 26 hours of paid work into a single 10-hour day.

In its survey of Florida outpatient surgery centers, The Post found similar Herculean performances in other specialties: 23% of ophthalmologists and 17% of orthopedic surgeons were paid for at least 12 hours of procedures in a single day — longer than the surgery centers where they worked were open.

The AMA says it's reviewing colonoscopies and other procedures, with updates expected in April. In the meantime, though, Medicare and private insurers (and patients with deductibles) could overpay substantially for months to come.

The AMA notes that because the relative value system is supposed to be budget-neutral, the committee's data can't increase overall Medicare spending. For each value that rises, others have to decrease. Fair enough. But overvaluing specialty procedures gives physicians incentives to perform more of them while primary care services are undervalued, an imbalance the AMA insists it has worked hard to fix.

The Medicare Payment Advisory Commission, the independent agency that advises Congress on Medicare, has been critical of the AMA committee for years, arguing that the panel's findings are vulnerable to bias and proposing that its work be reviewed by an expert committee or done by Medicare itself. Congress is considering legislation that would require Medicare to collect its own data and reduce values for overpriced procedures.

The time has come to either supervise the AMA committee's work more aggressively or have Medicare do the work itself. Even if the committee members all behave with the utmost professionalism, the potential conflict of interest throws a shadow over their work, and the moral hazard is simply too great.

USA TODAY's editorial opinions are decided by its Editorial Board, separate from the news staff. Most editorials are coupled with an opposing view — a unique USA TODAY feature.